Those of you with asthma - How do you cope day to day and competing?...

Chloe_GHE

Chloe_GHE

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Just curious to pick fellow 'limp lunged' people's brains about how you manage your asthma on a daily basis around horses and what you do on the day of the competition that helps.

I was diagnosed with allergy (dust, grass, cats, pollen, and feathers) and exercise induced asthma about 2 years ago when I also suddenly became weirdly allergic to loads of stuff resulting in unpredictable hives, and swellings (my lips swelled up so bad once I gave Pete Burns a run for his money!) :) since then I have been given a brown puffer and a blue puffer and antihistamines.

In typical 'I know best, self diagnosing style' I don't take my brown puffer everyday as I forget and also don't really want to be taking a steroid long term no matter how small a dose, so I carry my blue one about with me to take when I get wheezy. Now the allergies have stopped *touches wood* I don't take the antihistamines any more either as they were causing excess hhhmmm.... how do I put this nicely?.....I give up....excess spit and snot when running.

With the horses I keep them on shavings and haylage to minimise dust, obvs can't really avoid grass, changed all my lovely feather bedding to synthetic, and thank goodness our cat died several years back! ;)

So what do you do to improve your asthma?... on the day of comps I tend to use my puffer just before xc as that is the hottest, most aerobic phase.

Has anyone tried those nasal strips that rugby players use?... are there any alternative treatments that have helped you?... acupuncture?.....
 
The major thing with me was learning to breathe in time with the horse's gallop as i went XC. When i first started eventing i collapsed a few times when finishing due to not breathing properly on the way round, once ending up in an ambulance to A&E.

So now i make sure i breathe with them on the way round, in time with their gallop, and it really helps me recover better once we've finished.

That and always make sure i have my blue inhaler with me, and drink lots.
 
my main issue comes when im too hot i feel Claustrophobic and that causes my breathing to start to wheeze

So wearing lighter clothes has helped that allow your skin to breathe and keeping hydrated – always make sure I leave a water bottle and inhaler either with helper of steward at start box/ finish – if you explain there usually fine

with hayfever i find that menthol crystals (to enhale) help as i seem to get summer flu quite easily plus eye drops as im a weaper ;)
 
I've had it since i was about 8/9 as it runs in the family, dads severley allergic to horses and hay [yet he still makes it every year! ;)] and Mum's got hay and dust problems...They all take inhalers, and for a few years whhen i was 11/12/13 it was really bad but since then symptoms have died off and now only take inhaler when i need it!

Generally, try and avoid situations which might cause symptoms - but around here your nowhere without an inhaler so dont need to worry as someones always carrying one! But you can only control situations to a certain extent such as watering hay ect.
 
I also don't like to take steroid medication regularly (or any med if I can help it!). Because of this I only used to take my brown inhaler in the Winter and then just get by with my reliever when necessary. Last year I started taking a smaller does every day all year and i don't know whether it is a coincidence but I very rarely now need my reliever and I managed to get through an entire winter without getting a chect infection which is the first winter in ages...as usually the smallest cold ends up being a chest infection.

Maybe you could try using the preventer daily but in a smaller does - I take just one puff once a day before I clean my teeth each morning.
 
I've had fairly severe asthma since I was little as you know it doesn't sit well with horses. I use shavings and avoid very dusty hay, dealt with some the other week and it set me off needless to say it didn't go anywhere near the horse. The thing that made the biggest difference was swapping my medication I now take seretide as a 'preventer' and it has made a huge difference 3 years ago I was in hospital every winter on oral steriods regulary and taking my relievers daily, after a pretty bad stint in hospital with yet another chest infection I didn't really recover and was sent to the GPs from work as my wheezing was alarming my boss and saw a triage nurse who was amazed at my low doseage of Becotide reliever she was about to dish out the usual oral steriods when she suggested trying seretide. I have literally never looked back don't even take it every day very very rarely pick up my relievers, have not been in hospital since now I can ride run and do all the norma stuff without any concern about asthma at all, fingers crossed it will remain that way.
 
Thanks guys some useful tips. I might do a month's trial using my brown one each morning just one puff, and if no improvement will go back to docs and see what he says.

menthol crystals are on the shopping list, and I'm gonna but some anti snore strips and see how I get on with those for running :)
 
Chloe - The brown inhaler is what is known as a PREVENTER!!!!! It will NOT work unless you use it daily. The blue inhaler is a RELIEVER and only to be used when suffering shortness of breath. If you find you're using the blue inhaler regularly then you really need to get your medication changed.

There are five steps to asthma management as laid down by the British Thoracic Society and from what you've said you're at step 2 thus the amount of steroid you'll be getting through the brown inhaler that you use is minimal and the benefits will vastly outwiegh any of the issues that people perceive to be associated with the steroids.

Please please please use your inhalers as prescribed. What fantatical describes is no coincidence - using the preventer regularly will mean you should rarely need your reliever and you should become far less suscptible to chest problems.

Sorry for the rant, have just finished my masters degree in Pharmacy and we've done a lot on asthma management and it really riles me when asthmatics complain about their asthma being poorly managed but don't comply with the medication prescribed!

You may even find with regular use of the brown preventer that your asthma will get better and you can step back down to step 1 and just use a reliever, but that won't magically happen!
 
MegaBeast said:
Chloe - The brown inhaler is what is known as a PREVENTER!!!!! It will NOT work unless you use it daily. The blue inhaler is a RELIEVER and only to be used when suffering shortness of breath. If you find you're using the blue inhaler regularly then you really need to get your medication changed.

There are five steps to asthma management as laid down by the British Thoracic Society and from what you've said you're at step 2 thus the amount of steroid you'll be getting through the brown inhaler that you use is minimal and the benefits will vastly outwiegh any of the issues that people perceive to be associated with the steroids.

Please please please use your inhalers as prescribed. What fantatical describes is no coincidence - using the preventer regularly will mean you should rarely need your reliever and you should become far less suscptible to chest problems.

Sorry for the rant, have just finished my masters degree in Pharmacy and we've done a lot on asthma management and it really riles me when asthmatics complain about their asthma being poorly managed but don't comply with the medication prescribed!

You may even find with regular use of the brown preventer that your asthma will get better and you can step back down to step 1 and just use a reliever, but that won't magically happen!
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*sulks* (doesn't really want to admit to having asthma so think that ignoring puffers will make me better)
*sigh* I guess what you are saying is right, trouble is having only just been diagnosed with it and never having had (and noone else in the fam) it before I want to try and ignore the fact it's an issue but that's clearly not working :(

I have to use my blue one every time I run, otherwise I can't :(
what are the 5 steps?...

Ok I will give the brown one a go, but what I do find when I use it is that it gives me a cramped up chest and it makes me cough every time, unlike the blue one that just seems to make things better.

Thanks for the informed advice MB I'm just being a div really trying to deny the fact I can't just run through a cat filled dusty field whilst eating feathers without getting a little 'chesty' :)

*promises to take brown puffer every day for a month to see if it helps*
 
^^^Wot Megabeast said^^^

Get a spacer for your brown inhaler - unless you have good technique, it all ends up on the back of your tongue.

How often are you wheezy? Is it with exercise?
 
If you're having to take your blue one every time you run, ask your GP if you can have the long-acting version of the blue inhaler.
 
'Fraid I'm another one to vouch for taking your steroid one when you're meant to!! I used to use my blue one all the time (4-5 times a day) and forget to take my steroid one. Since being strict with myself about it, I barely use my blue one - seriously, I maybe take it once a month, if that.

And the more exercise I do now (since being on steroid), the better I am.

Always make sure I have blue one with me if at all times and Mr NJ has a spare blue in his camera bag when I'm competing, just in case.
 
Chloe...I too didn't like the fact that I had been diagnosed as asthmatic having always been very sporty as a child and never having a problem. It wasn't until I left school and started working full time with horses that it developed and even then I refused to believe I was asthmatic merely saying it was an allergy - of course it is asthma which is triggered by the allergies.
I went through exactly what you're saying, not wanting to take the preventer as I don't like taking medicine of any kind never mind steroids but I have finally learnt that just one puff each day, year round, seems to work for me.
I'm not sure if you already have one, but I have a spacer (used to have the big one but now a tiny one) and that ensures that the one small puff each day does get into my lungs and doesn't just sit on my tongue/ throat. It soon becomes habit to take it every day if you do it at the same time.
 
My sister is asthmatic, she went through a phase of not taking her preventative inhalers because she was trying to pretend it didn't exists. It landed her in hopsital on three seperate occasions, scaring the life out of my parents each time.

Working on breathing technique is good for any athlete let alone an asthmatic one - I used to work in a scuba diving centre, and we taught all the students about breathing control because it makes diving so much more enjoyable - at one point, my resting breathing rate was half that of my sisters - due to partly my increased control and partly due to her poorly controlled asthma.
 
I have trouble when I over do it, xc is the WORST. I use my blue inhalor before I get going as it clears me out, but if my asthma is in a really bad patch there is no way I can even ride in the school out of a walk and slow trot, I find I end up wheezing and have to stop after ten mins or so when I start to do more. Use your brown one asap, I'm lucky in the sense that my chest is only really triggered by either illness or being run down in general, not allergy related (however I dread having any sort of mild cold as it always brings on a real bad spell). I also use the equine america airways tonic stuff on myself (meant for horses really) but just a tiny dab is really strong and clears my chest before exercise nicely.
 
Chloe_GHE said:
Ok I will give the brown one a go, but what I do find when I use it is that it gives me a cramped up chest and it makes me cough every time, unlike the blue one that just seems to make things better.
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That could be down to poor inhaler technique... have you ever been shown how to use it? My understanding of how to use an inhaler was totally wrong and only when we were shown how to in a workshop did I realise - although have never had to use one myself.

Can totally understand and relate to the being in denial about it though, it's exactly how I am with any kind of illness/problem. I won't even admit to having a cold! Kind of think I'm entering the wrong profession sometimes.

If you find it just isn't working, then do go back and see your doctor, and if necessary ask to be referred to a specialist clinic, there are nurse run asthma clinics available that can be really helpful. There are a range of different medicines and also types of inhalers available. It may be a case of needing a different type of inhaler because you breathe too sharply/not enough etc. There are a lot of options available so don't settle for something that isn't quite right.
 
If the brown one is "cramping" you use the blue one first then use the brown one. My husband was dreadful when I first met him, since we got him on to this regime he has never *touches wood* had anything approaching a bad attack.

Just the blue one, then the brown one - he uses them first thing in the morning and last thing at night (cats in the bedroom!) - and no more fuss, he can forget he's got asthma!
 
Five Steps:

Step up/down management of chronic asthma
Step 1: Mild intermittent asthma

Prescribe an inhaled short acting beta2-agonist as short-term reliever for all patients with symptomatic asthma.

Step 2: Introduction of regular preventer therapy

Inhaled steroids are the most effective preventer drug for achieving overall treatment goals. They should be considered for any patient with:

* A recent exacerbations (in the last 2 years)
* Nocturnal asthma (waking with symptoms more than once a week)
* Day time symptoms or use of an inhaled short acting beta2-agonist more than 3 times per week

Regular use of bronchodilators alone may be linked with worsening asthma and asthma deaths and some patients may be non-compliant with their 'preventative' medication for varied reasons. Review medication use. Start treatment at a dose appropriate to symptoms between 200-800 mcg /day beclometasone propionate or equivalent (400 mcg/day is appropriate for many).

In the past, advice has been to double inhaled steroids early in an exacerbation. Evidence for being effective at lower dose (e.g. 200 to 400 mcg/day) is lacking but there is some evidence of efficacy switching from low to high dose inhaled steroids (e.g. 200 to 1000 mcg/day) early in an exacerbation. Current guidance advises commencing oral steroids early in an exacerbation.

Step 3: Add-on therapy

First choice as add-on therapy to inhaled steroids are inhaled long acting beta2 -agonists (LABAs) such as salmeterol or formoterol.

* Review after a trial of therapy - continue if successful in controlling symptoms. well.
* Discontinue after a trial of therapy if no benefit seen. Then, increase inhaled steroid dose to 800 mcg/day beclometasone propionate or equivalent. If control remains suboptimal consider a trial of another add on therapy such as leukotriene receptor antagonists or modified release theophylline.
* If benefit but partial control only, continue the LABA but increase inhaled corticosteroid to 800 mcg/day beclometasone propionate or equivalent.

Step 4: Poor control on moderate dose of inhaled steroid plus add-on therapy:

Recommendations at this step are based on extrapolated results as specific clinical trials are lacking and are consequently less evidence-based. Trial an additional fourth drug over six weeks (e.g. leukotriene receptor antagonist, SR theophylline or β2 agonist tablet) and increase inhaled steroid to high-dose ranges (up to 2000μg/day) are suggested strategies at this level.

Step 5: Continuous or frequent use of oral steroids

Where previous steps have failed to control a patient's asthma, the use of regular prednisolone is suggested. Oral steroid dose reduction is sometimes achieved by using high-dose inhaled corticosteroids. These patients should be under the care of a respiratory physician. They run higher risk of steroid-related side-effects and should be monitored for the development of:

* Hypertension
* Diabetes or hyperlipidaemia
* Osteoporosis
* Cataracts
* Adrenal suppression

Stepping down

Review treatment every 3 months. Step down if possible (but consider seasonal variation in symptoms, severity of asthma, risk of adverse effects, patient preference) and use the lowest possible dose of inhaled corticosteroid to control the asthma symptoms. When reducing inhaled steroids, cut dose slowly by 25-50% each time.
Combination products

Increasingly, combination inhalers of LABAs and low dose inhaled steroids (e.g. Symbicort® = formoterol and budesonide, Seretide®=salmeterol and fluticasone) are being marketed and used. These products are convenient since many patients are on maintenance dose of both types of drugs and should be expected to improve adherence. However they should only be used if the patient requires both drugs and has previously been stabilised on a dosage regimen that is deliverable by the combination inhaler. Using combined inhalers makes it harder to assess whether a patient still requires both drugs and in what doses and so the LABA or inhaled corticosteroid may not be stepped down appropriately.

They appear in the new British guidelines for the first time for adult patients at step 3 when the use of formoterol and budesonide combined inhalers may be stepped up from regular use as preventative treatment to rescue treatment (instead of a short-acting beta2-agonist) when symptomatic. This has been shown to be effective provided patients receive adequate education about their use.

http://www.patient.co.uk/doctor/Management-Of-Adult-Asthma.htm

PS the suggestion a few people have made about using a spacer for the preventer inhaler is an excellent one
 
Good post Chloe!

I got diagnosed with Asthma aged 14 after about collapsing at PC Camp (7 year cycle..hmmm!) Being told i had activity activated and allergy activated (including being allergic to dust, horses, cats, dogs....you know....everything we had at home) Struggled on for years with Blue, brown and even green inhalers which although were o.k, i was terrible within hours of using them. Eye drops, nose spray, antihistamine, i took all of the above before seeing/riding the horses! I went to live by the sea for a couple of years and was fine.....till i came home!!!! Drastic!

However now, my lovely, amazing, fantastic doctor has changed my life!! He's put me onto SYMBICORT, which is a shiney NEW RED breath actulated inhaler (no timing with puffers, just suck ;-0) and its an all in one and much less steriod but it builds up in your system and prevents attacks, rather than waits for them to happen, then try treat them! I take it 4 times a day, usually 2 puffs in morning, 2 at night, and keep it with me and if i'm competing/lesson a puff before, same with a run, have a puff before! After 18 years its the only thing that has made me feel normal, barely now wheeze at all and i also run and don't get any tightness! In fact i ran 26.2 miles on this stuff, so must be good, where as before i couldn't run for toffee, only because i couldn't breathe......extremely annoying after being very sporty at school etc before onset of Asthma!

As with the horses similar to you really, they are on rubber matting and shavings, steamed hay, but i take a nose spray, also wear a dusk mask all the time when mucking out, filling haynets, grooming, bathing etc, not very attractive, but its great! I also put vasaline or carmex around my nose and lips to try catch any dust before it sneaks in....and always shower after i've got really horsed up! Wear a cap to keep it out of my hair and i keep a pair of overalls at the stables to pop on and off and "leave the horse dust and rubbish on those at the yard!"

After spending weeks and months on nebulisers/hospital etc.....i've found this way has kept me away from them for years now......."massively touching wood!!"

You do find ways to help and i don't look the most attactive in my overalls, with cap, dustmask, sometimes wrap around sunglasses (esp when molting!) and a load of vasaline plastered around my face.....but hey ho......my asthma is better!!!

Would be well worth asking your doc about SYMBICORT....i know its expensive for them, so they may not have it....but they might just and be willing to swap you!
 
kit279 said:
If you're having to take your blue one every time you run, ask your GP if you can have the long-acting version of the blue inhaler.
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didn't even know such thing existed! Will deffo book an appt to ask about this. I have to use the blue one every time I run before I set off, if I don't I get 1/2k into the run and sound like a wheezing old man and can only do v shallow breaths :( Will ask about a spacer too as part of the reason I don't use the brown one is because it chokes me.
 
SamuelWhiskers said:
Good post Chloe!

I got diagnosed with Asthma aged 14 after about collapsing at PC Camp (7 year cycle..hmmm!) Being told i had activity activated and allergy activated (including being allergic to dust, horses, cats, dogs....you know....everything we had at home) Struggled on for years with Blue, brown and even green inhalers which although were o.k, i was terrible within hours of using them. Eye drops, nose spray, antihistamine, i took all of the above before seeing/riding the horses! I went to live by the sea for a couple of years and was fine.....till i came home!!!! Drastic!

However now, my lovely, amazing, fantastic doctor has changed my life!! He's put me onto SYMBICORT, which is a shiney NEW RED breath actulated inhaler (no timing with puffers, just suck ;-0) and its an all in one and much less steriod but it builds up in your system and prevents attacks, rather than waits for them to happen, then try treat them! I take it 4 times a day, usually 2 puffs in morning, 2 at night, and keep it with me and if i'm competing/lesson a puff before, same with a run, have a puff before! After 18 years its the only thing that has made me feel normal, barely now wheeze at all and i also run and don't get any tightness! In fact i ran 26.2 miles on this stuff, so must be good, where as before i couldn't run for toffee, only because i couldn't breathe......extremely annoying after being very sporty at school etc before onset of Asthma!

As with the horses similar to you really, they are on rubber matting and shavings, steamed hay, but i take a nose spray, also wear a dusk mask all the time when mucking out, filling haynets, grooming, bathing etc, not very attractive, but its great! I also put vasaline or carmex around my nose and lips to try catch any dust before it sneaks in....and always shower after i've got really horsed up! Wear a cap to keep it out of my hair and i keep a pair of overalls at the stables to pop on and off and "leave the horse dust and rubbish on those at the yard!"

After spending weeks and months on nebulisers/hospital etc.....i've found this way has kept me away from them for years now......."massively touching wood!!"

You do find ways to help and i don't look the most attactive in my overalls, with cap, dustmask, sometimes wrap around sunglasses (esp when molting!) and a load of vasaline plastered around my face.....but hey ho......my asthma is better!!!

Would be well worth asking your doc about SYMBICORT....i know its expensive for them, so they may not have it....but they might just and be willing to swap you!
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Yes so annoying to know you are fit but just can't carry on because of your lungs, forgot my puffer the other day started run and 1/2 k in chest just vacuum packed up, could hardly breath so just had to walk and watch my OH run off ahead of me, depressing and frustrating!

SYMBICORT have written it in my filofax will ask GP about it, can't get to grips with my brown one it chokes me so maybe that would be a better idea.

Yes I try to de-horse like you at the yard and leave it behind so it doesn't come home and bug me there. went for a run by the sea the other day, felt like I had new lungs, shame im such a land lover otherwise the seaside would be a bit more appealing! :)

Thanks for the tips everyone will try to use brown one correctly and book to see GP about alt treatment
 
The brown one is so harsh, used to choke me too and felt like it wasn't getting "down" used to give me such a sore throat.

It is the one you need though, by the sounds of it, as it is the preventer (as already said here!) so perservere with it till you get in at the docs, a spacer will help you take it, as already suggested if they don't have any other medication, but if you are VERY assertive with them, they really ought to review you and change your medication!

Hope you get it sorted as know its a miserable feeling!

p.s maybe we can move a bit of the sea to the land.......tis an amazing tonic for asthmatics!
 
Similar history - allergic to EVERYTHING and then gradual slide into a constant round of chest infections, pneumonia and general unpleasantness.

I'm now pretty much off everything. :) Although I still have both and use the blue one intermittently, particularly if something has set me off near to bedtime and I absolutely don't sleep if I think I'm suffocating! Once and awhile, if something really dangerous is flowering or similar, I have to use the steroid for a time to get the status back to quo. All that said, though, I wouldn't use my blue one more than a couple of times a week on average.

I do take antihistimines (try a couple - they seem to work very differently for different people) if I'm in a situation where I can't avoid something that's likely to set me off.

The biggest things that have made a difference, I hate to say in my boring grown up way, are management related. First, I gave up ALL dairy products years ago. It nearly killed me and I was like a jonesing junkie in the dairy aisle at the supermarket, but after a couple of months I couldn't believe the difference. I do now occasionally have some cheese or ice cream or similar - what's life without a bit of cheating :D - although I definitely notice if I get too cavalier about it. Tomatoes are another thing that sets me off, which apparently is true for a lot of people with asthma.

The other, I try to get enough sleep. I know, I know how boring and unnecessary. But particularly in the winter, if I got a cold and didn't shake it quickly, I was off and running on my way to bronchitis/pneumonia. So now, if I start to get something, I go to bed and sleep it off as soon as I can.

Remember, too, like most things, if you're not getting better, you're getting worse. Medication is wonderful - if used correctly ;) - but every time you get bad enough to need it, you're potentially doing yourself more damage. It's a balance, to be sure, but if you were a horse you wouldn't just pump in the drugs and not do anything for the underlying issue, would you? ;)
 
I got carbon monoxide poisoning when I was younger (our house blew up!) and since then had intermitent asthma... I have found my asthma is always worst this time of year and in the colder months - going in and out of the hot & cold! During these times I ALWAYS take my brown inhaler and it really does help! Instead of getting through a blue inhaler every 2 weeks it lasts a lot longer as I hardly need it. But I do take it with a spacer otherwise I end up with a really sore throat...

When I was competing at PC I used to swim a lot and this really really helped and it still does now. Walking also helps if you can... Jogging never helped me in anyway and always made me worse when the wheezing started.

With swimming you have to control your breathing by holding your breath when your head is in the water. This sets you up into a rhythm when you start breathing heavier - this type of rhythm will help you when competing and having practised it when swimming you should find that your lungs can cope better and you can control your tight chest if you need to.
 
Taking inhaler morning and night definately helps! I get soo nervous before going xc not because of the xc itself but because i know that i will hardly be able to breathe at the end. However just did burgie this weekend and when walking the course was more worried about my breathing than anything else.
I just concentrated on breathing deep breaths in and out and after a few jumps it just comes naturally. I actually didnt collapse after the finishing line :) And reliever before definately helps. I was also going to try those nasal things too
 
I have exercised induced asthma and I event. I take blue inhaler before & after XC round which makes it bearable! If its particularly hot or my horse pulls badly I end up sounding like a dememnted sea lion (I blended in really well at Longleat!)....
 
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